Center Child & family application

Thank you for your interest in enrolling at Momentum Early Learning! Please fill out one of the applications below depending on which campus you would be interested in. Once you apply, a Center Director will reach out to give more information and set up a tour.

SUSSEX campus

Number of Children

Please select number of children you would be looking to enroll.

Infant Due Date

YYYY

Children's Names & Birthdates

Days Attending

Please check all that apply. *Please note that 2 or 3 days per week for ages 2 and under is not offered.

Monday

Tuesday

Wednesday

Thursday

Friday

Requested Start Date

YYYY

Parent's Name

First Name

Last Name

Parent's Name

First Name

Last Name

Preferred Contact Email

Preferred Phone Contact

(###)

###

####

How did you hear about Momentum Early Learning?

Website Search

Word of Mouth

Current Family Referral

Why are you interested in having your child(ren) attend Momentum Early Learning?

Please list any important developmental information for Momentum Early Learning to know for/about your child(ren).

Germantown campus

Number of Children

Please select number of children you would be looking to enroll.

Infant Due Date

YYYY

Children's Names & Birthdates

Days Attending

Please check all that apply. *Please note that 2 or 3 days per week for ages 2 and under is not offered.

Monday

Tuesday

Wednesday

Thursday

Friday

Requested Start Date

YYYY

Parent's Name

First Name

Last Name

Parent's Name

First Name

Last Name

Preferred Contact Email

Preferred Phone Contact

(###)

###

####

How did you hear about Momentum Early Learning?

Website Search

Word of Mouth

Current Family Referral

Why are you interested in having your child(ren) attend Momentum Early Learning?

Please list any important developmental information for Momentum Early Learning to know for/about your child(ren).

Waukesha Campus

Number of Children

Please select number of children you would be looking to enroll.

Infant Due Date

YYYY

Children's Names & Birthdates

Days Attending

Please check all that apply. *Please note that 2 or 3 days per week for ages 2 and under is not offered.

Monday

Tuesday

Wednesday

Thursday

Friday

Requested Start Date

YYYY

Parent's Name

First Name

Last Name

Parent's Name

First Name

Last Name

Preferred Contact Email

Preferred Phone Contact

(###)

###

####

How did you hear about Momentum Early Learning?

Website Search

Word of Mouth

Current Family Referral

Why are you interested in having your child(ren) attend Momentum Early Learning?

Please list any important developmental information for Momentum Early Learning to know for/about your child(ren).

Center Child & family application

SUSSEX campus

Germantown campus

Waukesha Campus

Momentum Early Learning

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